Broader study of cancer is sought

Lawmakers want state to fund a 2nd look at firefighters' risk

Old practices at academy questioned

$25,000 Hopkins investigation found no direct cause for cases

August 03, 2005|By Phillip McGowan | Phillip McGowan,SUN STAFF

The state should fund a more comprehensive study looking at a possible link between cancer cases among some former Anne Arundel County firefighters and decades-old training practices at the county's fire academy in Millersville, several county legislators said this week.

The legislators' comments followed the release of a Johns Hopkins University study that found county firefighters had a "somewhat greater" risk of getting cancer than the general public, but was unable to determine whether exposure to burned fuel at the academy in the 1970s led to some cancer cases. Public health researchers recommended a broader look at the issue than the $25,000 state-funded study provided.

Some lawmakers said the General Assembly should fund the study if state officials don't give it the green light.

"The direct causation is elusive, but that shouldn't deter us from identifying those environmental factors in an effort to save lives," said Del. John R. Leopold, a Pasadena Republican who is running for county executive next year.

County Executive Janet S. Owens supports the idea of an additional study - but one that is national in scope and federally funded.

"Are there things we can do to provide protection for our firefighters?" said Owens, a Democrat.

Talk of what to do next has become a topic of concern among political leaders and Anne Arundel County firefighters. A 10-month investigation released last week by Johns Hopkins public health officials revealed that at least 17 firefighters have developed at least one form cancer.

But the 43-page study failed to establish whether fuels laden with cancer-causing agents - burned from 1971 to 1979 at the Millersville academy - led to firefighters developing cancer.

State health and county Fire Department officials have expressed uncertainty that a more expensive study - experts say it could cost hundreds of thousands of dollars - would produce more conclusive results. They said most research of cancer clusters fails to uncover a conclusive cause.

"The difficulty of these studies is trying to sort out the exposure to occupational hazards," said Dr. Michelle A. Gourdine, deputy secretary for public health services at the state Department of Health and Mental Hygiene.

But the lead investigator, Dr. Jonathan Samet, said last week that the results "speak to the need to do a formal study."

Elizabeth Ward, a researcher of cancer clusters for the American Cancer Society, yesterday described the Hopkins study "as a good job on the first step." But she added: "Clearly the resources were inadequate" to take a definitive look at the subject.

The local firefighters union and a growing number of state leaders concur with the assessment of Samet, who as chairman of the epidemiology department at Hopkins' Bloomberg School of Public Health is considered one of the most highly respected researchers in his field.

Samet will present his findings at a public hearing next week in the county, although a location and time has not been determined.

In the meantime, Leopold wants to use money from the state's cigarette restitution fund to support an in-depth study through the University of Maryland medical system.

Leopold said that if that initiative fails, he will petition for money at the next General Assembly session.

Two other members of the county delegation - Sen. Philip C. Jimeno, a Democrat, and Del. Terry R. Gilleland Jr., a Republican - said the state should provide funding.

Bob Stevens, president of the firefighters union, said the 10-month Hopkins study "only touched the surface of the issue."

More data available

Funding limited Samet's team to interviewing ill Anne Arundel firefighters and their families who volunteered to participate in the study. Howard and Prince George's counties, Annapolis and Baltimore-Washington International Airport have sent their firefighters to training in Millersville for the past three decades, but those outside jurisdictions were not included in the study.

Epidemiologists and other investigators of cancer clusters said that developing a large enough sample size is a costly yet necessary component of a complete study.

"You can't just learn about an excess of cancer by interviewing people," said Ward, director of surveillance research for the American Cancer Society. "You have to look at records over the past 20 or 30 years.

"You have to get a sense of how many people were at the training facility," said Ward, who reviewed the Hopkins study.

Firefighters are more prone to developing cancer than other groups - a finding that's supported by studies in Chicago and Seattle. That greater risk complicates the task of trying to discern a specific cause of a cancer cluster, researchers said.

Difficult task

"Cancer is a common disease that's caused by so many factors," said Dr. Beverly Kingsley, an epidemiologist for the National Center for Environmental Health at the Centers for Disease Control and Prevention.

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